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生物制剂治疗鼻息肉型慢性鼻-鼻窦炎的缓解情况:真实病例经验

Remission in chronic rhinosinusitis with nasal polyps treated with biologics: a real-life experience.

作者信息

Loperfido Antonella, Cavaliere Carlo, Ciofalo Andrea, Bugani Marcella, Begvarfaj Elona, Millarelli Stefano, Bellocchi Gianluca, de Vincentiis Marco, Masieri Simonetta

机构信息

Otolaryngology Unit, San Camillo Forlanini Hospital, Circonvallazione Gianicolense 87, Rome, 00152, Italy.

Department of Sense Organs, Sapienza University, Rome, 00185, Italy.

出版信息

Eur Arch Otorhinolaryngol. 2025 Sep;282(9):4681-4690. doi: 10.1007/s00405-025-09619-y. Epub 2025 Aug 4.


DOI:10.1007/s00405-025-09619-y
PMID:40759784
Abstract

PURPOSE: Biologics targeting the underlying inflammation in chronic rhinosinusitis with nasal polyps (CRSwNP) not only alleviate symptoms but also provide potential disease-modifying effects. This has redefined treatment goals in CRSwNP, emphasizing the concept of achieving disease remission as proposed by the EPOS2020/EUFOREA expert panel. Remission in CRSwNP is defined as sustained control for at least 12 months, along with the absence of active disease as assessed by nasal endoscopy. The purpose of this study was to identify patients with severe CRSwNP who achieved disease remission during the first two years of Dupilumab treatment. METHODS: This real-life, observational, retrospective study evaluated the effectiveness and safety of Dupilumab in patients with severe, uncontrolled CRSwNP over two years. Remission was assessed taking into account the latest EPOS2020/EUFOREA expert panel and currently available expert opinion on the topic. Data were collected at baseline and after 1, 3, 6, 9, 12, 18, and 24 months, focusing on nasal polyp score (NPS), symptoms, olfactory function, and quality of life (QoL). Additionally, the safety profile was evaluated by monitoring side effects and eosinophil blood count. RESULTS: A total of 30 patients (19 males, 11 females; mean age 53.7 years) were included. Dupilumab treatment led to significant clinical improvements, including a reduction in NPS, relief of nasal symptoms, and notable improvements in olfactory function and QoL, as demonstrated through SNOT-22 and VAS scores. Twenty-three patients (77%) achieved disease remission. CONCLUSION: This retrospective study confirms the efficacy of Dupilumab in managing difficult-to-treat, type-2 inflammation-driven CRSwNP, with a high percentage of patients achieving remission. Further studies with larger cohorts along with universal guidelines establishing validated criteria, including specific cut-off values, for a standardized definition of remission in CRSwNP are required.

摘要

目的:针对伴有鼻息肉的慢性鼻-鼻窦炎(CRSwNP)潜在炎症的生物制剂不仅能缓解症状,还具有潜在的疾病改善作用。这重新定义了CRSwNP的治疗目标,强调了实现如EPOS2020/EUFOREA专家小组所提出的疾病缓解的概念。CRSwNP中的缓解定义为持续控制至少12个月,且经鼻内镜检查评估无活动性疾病。本研究的目的是识别在度普利尤单抗治疗的头两年实现疾病缓解的重度CRSwNP患者。 方法:这项真实世界、观察性、回顾性研究评估了度普利尤单抗在两年内对重度、未得到控制的CRSwNP患者的有效性和安全性。根据最新的EPOS2020/EUFOREA专家小组意见以及目前关于该主题的专家意见对缓解情况进行评估。在基线以及1、3、6、9、12、18和24个月后收集数据,重点关注鼻息肉评分(NPS)、症状、嗅觉功能和生活质量(QoL)。此外,通过监测副作用和嗜酸性粒细胞计数来评估安全性。 结果:共纳入30例患者(19例男性,11例女性;平均年龄53.7岁)。度普利尤单抗治疗带来了显著的临床改善,包括NPS降低、鼻部症状缓解以及嗅觉功能和QoL的显著改善,这通过SNOT-22和VAS评分得以证明。23例患者(77%)实现了疾病缓解。 结论:这项回顾性研究证实了度普利尤单抗在治疗难治性、2型炎症驱动的CRSwNP方面的疗效,有很高比例的患者实现缓解。需要开展更大队列的进一步研究,并制定通用指南,确立用于CRSwNP缓解标准化定义的经过验证的标准,包括特定的临界值。

相似文献

[1]
Remission in chronic rhinosinusitis with nasal polyps treated with biologics: a real-life experience.

Eur Arch Otorhinolaryngol. 2025-9

[2]
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Medicina (Kaunas). 2025-8-15

[3]
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Medicine (Baltimore). 2025-8-8

[4]
Long-term efficacy and safety of different biologics in treatment of chronic rhinosinusitis with nasal polyps: A network meta-analysis.

Braz J Otorhinolaryngol. 2025-4-25

[5]
Two-Year Data of Tapered Dupilumab Shows High Effectiveness in Chronic Rhinosinusitis with Nasal Polyps With Nonsteroidal Anti-inflammatory Drug-Exacerbated Respiratory Disease.

Allergy. 2025-6

[6]
Efficacy of different biologics for treating chronic rhinosinusitis with nasal polyps: a network meta-analysis.

Eur Arch Otorhinolaryngol. 2025-2

[7]
Real-world effectiveness of dupilumab in a European cohort of chronic rhinosinusitis with nasal polyps (CHRINOSOR).

J Allergy Clin Immunol. 2025-2

[8]
Efficacy of Dupilumab in the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP): a multicentric real-life study.

Eur Arch Otorhinolaryngol. 2025-7-12

[9]
Systemic and topical antibiotics for chronic rhinosinusitis.

Cochrane Database Syst Rev. 2016-4-26

[10]
Dupilumab for refractory chronic rhinosinusitis in eosinophilic granulomatosis with polyangiitis.

Rheumatology (Oxford). 2025-5-1

本文引用的文献

[1]
Remission in chronic rhinosinusitis with nasal polyps (CRSwNP).

Rhinology. 2025-4-1

[2]
Effect of Dupilumab in CRSwNP Sinonasal Outcomes from Real Life Studies: A Systematic Review with Meta-analysis.

Curr Allergy Asthma Rep. 2025-2-5

[3]
Real-world effectiveness of dupilumab in a European cohort of chronic rhinosinusitis with nasal polyps (CHRINOSOR).

J Allergy Clin Immunol. 2025-2

[4]
Dupilumab Induces Long-Term On-Treatment Clinical Remission in Patients With Type 2 Asthma.

J Allergy Clin Immunol Pract. 2025-1

[5]
Nasal endoscopy score thresholds to trigger consideration of chronic rhinosinusitis treatment escalation and implications for disease control.

Rhinology. 2025-2-1

[6]
Comparison between clinical and cytological findings in chronic rhinosinusitis with nasal polyps treated with Dupilumab.

Eur Arch Otorhinolaryngol. 2024-12

[7]
Real-Life Evidence of Mepolizumab Treatment in Chronic Rhinosinusitis with Nasal Polyps: A Multicentric Study.

J Clin Med. 2024-6-18

[8]
Long-Term Perspectives on Chronic Rhinosinusitis with Nasal Polyps: Evaluating Recurrence Rates after Functional Endoscopic Sinus Surgery in the Biologics Era-A 5-Year Follow-Up Study.

J Pers Med. 2024-3-10

[9]
EPOS2020/EUFOREA expert opinion on defining disease states and therapeutic goals in CRSwNP.

Rhinology. 2024-6-1

[10]
Clinical Remission in Patients Affected by Severe Eosinophilic Asthma on Dupilumab Therapy: A Long-Term Real-Life Study.

J Clin Med. 2024-1-4

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